Complications of prematurity that may require surgical intervention

M. Z. Schwartz, S. B. Palder, K. R. Tyson and C. C. Marr
Department of Surgery, University of California, Davis Medical Center, Sacramento 95817.

Many complications related to prematurity may require surgical intervention. Between July 1981 and July 1987, treatment of patent ductus arteriosus (PDA) (228 patients), necrotizing enterocolitis (NEC) (49 patients), and complications of high-pressure ventilation (eight patients) was reviewed. A PDA was ligated in 136 patients, with one death and one complication. Ninety-two patients had treatment with indomethacin, with 35 failures. A PDA was associated with NEC in 37 of the 49 patients, with a 73% mortality when they occurred within 72 hours of each other. Two patients died following pulmonary resection for lung cysts. The two patients with pneumoperitoneum and pneumopericardium were successfully treated with tube drainage. A PDA ligation was successful, with low mortality and morbidity. Treatment with indomethacin was unsuccessful in 38% of patients. There is a high mortality when NEC and PDA occur within 72 hours of each other.